In this project we propose to expand our Patient Outcome Research Team (PORT) study of cataract extraction, currently underway in the United States, to include Manitoba, Canada and Denmark. The primary purpose of this project is to collect data on a broader spectrum of 1) patterns of medical practice; 2) physician attitudes and beliefs; and 3) patient expectations than are available in the United States and to assess the impact of these factors on patient outcomes and satisfaction. Preliminary data suggest that the rate of cataract extraction, the threshold for cataract extraction, the waiting period to have a cataract extraction, and various components of the management of cataract patients in Manitoba and Denmark differs from those in the United States. We chose Manitoba and Denmark because of the similarity in the availability of medical technology and clinical training, the strength and experience of the research teams, and the availability of data that can be compared to the data already being collected in our PORT project. We plan to adapt the methodology developed in our current PORT study to account for international differences in institutions, language, medical practice, and culture and to. analyze the data in conjunction with our current PORT.